Once more, Christmas is upon us. A time for family and friends. A time for laughter and love. A time for life. Memories (or the anticipation) of young children yelling and laughing as they run to the Christmas tree to see what Santa brought them. A child’s sweet, innocent laughter, those angelic faces reflecting boundless excitement fills our hearts with incredible joy.

And yet, for parents like me, parents who have had a child taken, it is also a time reminding us of our loved ones who are so missed. We grieve.

At this time of the year, we are so loath to let others see that grief within us After all, it is a universal time of joy. Conflicting feelings abound. One of our most fervent Christmas wishes is that others simply embrace more fully their families, their beloved children, their loved ones. And we search for words to convey that hope. Words that sometimes best come from others.

I wonder whether gifted authors understand that their words can resonate for generations? Do they understand that they are mere conduits for a message so much greater than themselves?  Do they understand that sometimes the written word touches us in a way that does not diminish over the years?

In 1993, Richard Paul Evans self-published a short book entitled, “The Christmas Box.” It was intended to be a story of love directed to his daughters.

The book centers around a young man, Richard, his wife and their young daughter, Jenna. Like so many young men, Richard places great emphasis on his career to the exclusion of his family, particularly Jenna.

In order to save money, Richard and his family move into a grand, Victorian home owned by an elderly woman, Mary. This arrangement includes the family caring for some of Mary’s needs. Then, Mary sees that Richard is trading diamonds for coal. And as such, she tries to inspire him to find that which is important.

While in the house, Richard finds a box, a Christmas box.  The Christmas box, originally intended to hold a Bible, has within it letters that Mary has written to a deceased loved one. Through the discovery of this box and the letters within, Richard discovers the true meaning of Christmas … the true meaning of love.

I cannot improve upon the author’s words. I can only quote his incredible message to us all:

“I sat down in the rocker in front of the illuminated Christmas tree and lay my head in my hands. Somewhere between the angel and Mary’s house I had figured it out. The first gift of Christmas. It just came. It came to my heart. The first gift of Christmas was love. A parent’s love. Pure as the first snows of Christmas. For God so loved His children that He sent His son, that we might someday return to Him.

“I understand what Mary had been trying to teach me. I stood up and walked up the stairs where my little girl lay sleeping. I picked up her warm little body and, cradling her tightly in my arms, brought her back down to the den. My tears fell on her hair. My little girl. My precious little girl. How foolish I’d been to let her childhood, her fleeting, precious childhood slip away. Forever. In my young mind everything was so permanent and lasting. My little girl would be my little girl forever. But time would prove me wrong. Someday she’d grow up. Someday she’d be gone and I would be left with the memory of giggles and secrets I might have known.

“Jenna took a deep breath and snuggled close for warmth. I held her little body tightly against mine. This was what it meant to be a father, to know that one day I would turn around and my little girl would be gone. To look upon the sleeping little girl and to die a little inside. For one precious, fleeting moment, to hold the child in my arms, and would that time stood still.

“But none of that mattered now. Not now. Not tonight. Tonight Jenna was mine and no one could take this Christmas Eve away from me but me. How wise Mary had been. Mary, who knew the pain of a father sending His son away on that first Christmas morn, knowing full well the path that lay ahead. Mary understood Christmas. The tears in the Bible showed that. Mary loved with the pure, sweet love of a mother, a love so deep that it becomes the allegory for all other love. She knew that in my quest for success in this world I had been trading diamonds for stones. She knew, and she loved me enough to help me see. Mary had given me the greatest gift of Christmas. My daughter’s childhood.”

The cold winds of anguish and grief are strong enough to put a frost on the heart of many people. But not me. I have a little warrior who helped so many before she was taken. A little warrior who, until my last day, will continue to inspire me. A little warrior who taught me the true meaning of love.

And so, during the Christmas Season, and for the rest of the year, embrace your beloved children. Laugh with them. Tell them you love them. As only a parent can. I love you Morgan. I love you Hanford (my beloved son). Each day, you teach me new lessons in how to be a better daddy, a better man.

And I certainly cherish that as my Christmas present.

Yesterday, Sunday, October 30, 2022, marked the sixth year commemoration of when my beloved daughter Morgan, drew her last breath. I was holding her hand that dark night. Her brother, my son, was in the room. At 11:31 p.m., the physician’s assistant gently whispered, “She’s gone.”

For the first time, I am forced to revisit that dark night once again on Sunday, the day of the week that my life as I knew it, ended. And yet yesterday in Dallas, the day was a “Chamber of Commerce” day. A brilliant robin’s egg blue sky having been washed clean by days of rain. A glorious temperature. The night brought a picturesque crescent moon illuminating the night sky.

Nonetheless, until the end of my days, that dark, horrible Sunday night will remain a personal tragedy. Morgan’s friends have moved on as surely they must. They have started their own families. To those who were in treatment with Morgan, those wonderful souls have likewise moved on with their lives. As for the eating disorder community, Morgan is merely a statistic and a forgotten statistic at that. However to her daddy, Morgan will always be the catalyst for my soul connecting with me.

When a child is claimed by this illness, a parent is filled with unspeakable pain. Depression. Remorse. Anguish. Nothing can change that reality. No insightful words designed to inspire others. We not only feel the loss, we live the loss.

And to the eating disorder community, we are a living reminder of its failure. They shake their angry fists and yell loudly to whomever will listen, “Once every 52 minutes, a person dies from an eating disorder.” But that is merely a statistic. That is merely a number. That statistic does not have a face. That statistic is not a person. That person does not have a life. That person’s humanity is stripped away. It is far easier to classify those who have been taken as a mere statistic.

The parents who have been left behind make people uncomfortable. Our faces of grief are the living reminders of the community’s failure. It would be so much easier if we would simply go away. And sadly, most do go away. To mourn in isolation. To let their grief, individualistic as it is, consume them alone.

When an annual death day arrives, a parent rises knowing that that day will certainly bring sadness as memories come flooding back. You wonder “what if?” What children would they have brought into the world? What joy and happiness would they have experienced? What greatness would have been within their grasp?

That day a parent walks a razor’s edge of emotion … the slightest nudge can send one falling into a chasm of despair. And yet, life, the endless possibilities that life seems to offer, keep finding ways to intervene, to keep one walking on that razor’s edge.

October 30 will continue each and every year. And in our grief and pain, we must surely embrace the reality that life belongs to the living. Life is about laughter and love. It is about experiencing life to the fullest. Recognizing the simple things which exist. The smile on a baby’s face. Stolen kisses between lovers. A gentle breeze on your face. Our senses bringing wonderful, yet subtle aspects of life and the living to us.

11:31 p.m. beckons.

I am sitting on the patio in front of the house. The inflatable dragon standing tall. The red Christmas lights in the Yaupon tree ablaze. (I know. I know. The company which installed them last year was in the neighborhood this past week, reached out and I caved.)

I settle in with a Cuban cigar (thank you to Dra. Eva Trujillo for holding a conference in person in Mexico which I attended and of course resulted in me bringing those little gifts back to the Republic of Texas), a glass of bourbon neat, music playing on my iPhone. The moon is beautiful. The gentlest of wind. The aria, “O Mio Babbino Caro” is found on my playlist.

And tears come so very easily. Memories of a life taken far too soon. But pain simply will not exist by itself no matter how hard I focus on that. Other thoughts, feelings, and emotions come. I have been surrounded by love. By laughter. By sweet, innocent children. By people who care. By people who love. So much has strengthened and bolstered me all day. And I know that I am not alone. I embrace the two handwritten notes of love written by two young angels who live down the street. I understand that even in my solitude, I am not alone. And never will be.

Then it dawns on me. I am not alone because I am so well-loved. After all, I can be a cantankerous, pot stirring curmudgeon. That person responsible for a number of “Steven Dunn Voodoo Dolls” being sold on the dark web!

I am not alone, and never will be alone, because of how well-loved my Morgan is. The strength and hope she inspired in others. The lives that she helped save when she was here. Her memory still inspiring others to recover. Even in her physical absence.

How wrong that physician’s assistant was six years ago. Her words, “She’s gone” could not be more incorrect. Morgan is not gone.

And the biggest drawback is that I can no longer just cling to her memory by myself. A part of her belongs to each person she inspired, and still inspires to recover. To once again, find laughter, love, life and hope.

To be well-loved. In the darkness of that night, the full realization hits. Morgan’s face is not representative of failure. No. She is the purest representation of life itself.

And for a daddy who so misses her, that is an incredible gift to cherish.

Sometimes a message of grace, of love, of joy is sent to you. It often comes from an unexpected place and an unexpected time. But, from wherever it comes, it lifts your head, your heart, your soul. When you despair, when you start to feel yourself lost, it lights that one candle in your darkness. It illuminates and keeps shadows of despair safely away.

October 20 was the anniversary of my latest rotation around the sun. When asked my age, my response is usually something like, “Well, chronologically I am XXX years old. Mentally, I am about 35 years old. Emotionally, I am about 12 years old. So, it evens out to about 36 years.”

But this year is different. The reality of the end of life hangs heavily over me. Monday, October 24 will mark the 3^rd commemoration of my dad transitioning. November 13 will be the second commemoration of my older brother being taken. My brother who was the picture of health. Suddenly, gone.

Sunday, October 30 will mark the 6^th commemoration of my beloved daughter, Morgan being taken. For the first time, this date falls on the same day of the week on which Morgan was taken. A Sunday night. Memories of that horrible, dark Sunday night. And the burden seems beyond measure.

Then, as you feel your despair, you receive a message. A message from an unexpected source. A message of hope. A message of joy. A message from an angel freed from her pain, from the heartache of this illness. A family at long last freed.

In this instance, about 18 months ago, a mother reached out to me. We talked. We talked of her daughter down here in Dallas. In the grip of her eating disorder. The pain was so incredibly hard. This mother and her spouse met with Patti and me at a restaurant here in the Dallas area. We talked. We shared. We bonded.

Fast forward a few weeks and her daughter needed a ride to the DFW Airport. Her mom actually thought it may have been an imposition. To the contrary.

Of course you will do this. Gladly! You only hoped, you wished you could do more. On the drive to the airport, I felt the fear within this young soul. The pain. The uncertainty. You try to find the “right words.” You talk of everything except eating disorders. And then finally, you connect over something so unexpected. The joy of a Christmas tree and Christmas tree farms. The shared memories from different states, from different generations. And you jointly embrace that.

You help get her on the plane for her trip home. You immediately text her mom and tell her that her angel is on the way. Afterwards, you have communication with her mom for a while. And as life marches inexorably on, you lose touch as others come into your life needing help or maybe, just someone to listen to.

And then in my current despair, in my dread of the commemoration of the upcoming remembrances of death, I received a message. A message of life. A message of hope. A message of a future which is now being embraced. This incredible mom gave me permission to share the loving message she sent to me. She texted me the following:

“Hello Steven…I wanted to put a smile on your face. Last we spoke, things went from bad to worse. My daughter started on hospice last November after 7 long and painful years. But then…things started to change. Fast forward to today, she is in complete recovery from her ED and depression. Weight restored and then some for over 6 months now. Zero behaviors or urges. Working full time, new healthy friends…thriving. And all out of treatment. It’s amazing and wonderful. I’m one happy mama and just enjoying each and every day with her healthy. Just wanted you to know and to thank you once again for all you did to help us along the way. Best to you always!”

And then another message:

“Another recent picture…of her Instagram post, reflecting. Brings me so much joy. After all you do, year after year, to help families like mine, I imagine you don’t see enough healthy outcomes. I know this horrible evil disease can resurface at any time but for now, each day is a blessing. And for the record, you did much more than encourage me. Resources, networking, support, encouragement…and that ride to the airport. You made a difference in our lives. Grateful. And blessed. 😊”

Tears were in my eyes as my heart was lifted. I hope one day this brave mom will know that I am the one who is blessed. Blessed by her. Blessed by her regaining laughter, joy, love and life!

My heart felt emboldened. And once again, I was filled with the beauty, grace and love of a recovered angel. And a mom and dad who believed in her.

What a gift. What a precious, precious gift.

The mid-term elections are fast approaching. Within a matter of weeks, our airwaves will be inundated with 30 second spots extolling the virtues of a particular candidate.

Soft, soothing music, or rousing patriotic anthems playing in the background as the special interest groups funding that candidate tells us that its candidate is a combination of Mother Theresa, Nelson Mandela, George Washington and Martin Luther King, Jr.

Or more likely, that 30 second spot, with background music of a dramatic, alarming dark theme will warn us that a certain candidate is first cousin to the Anti-Christ and seeks to watch the world burn if he/she can be “King of the Ashes.”

And as our two major political parties, Tweedledum and Tweedledee continue to propagate their political agenda, that is, “The Needs of the Party are Greater than the Needs of the Republic,” the victims of this mindless, ever increasing power grab are you and me, the public residing in what was once, this great Nation.

National networks which once were looked upon as revered, responsible outlets for reporting news with integrity and honesty have become nothing more than public relation shills for Tweedledum and Tweedledee.  

The growing, detrimental impact of this unethical gamesmanship is not just increasing but is becoming devastatingly harsh and cruel. And our mental health is being impacted.

In 2017 and again, in 2020, studies were conducted on the impact of politics on the mental, physical and social health of US citizens. The results were alarming.

Some of the findings of these studies were as follows:

“Based on the 2019–20 Census Bureau population estimates, the resident population of the United States included approximately 255 million adults at the time of the 2020 survey. Based on that number, the findings from the pre-election survey suggest that somewhere between a fifth and a third of adults—roughly 50 to 85 million people—blame politics for causing fatigue, lost sleep, feelings of anger, loss of temper, as well as triggering compulsive behaviors (e.g. difficulty in stopping thinking about politics and consuming political information), and difficulties in impulse control (e.g. posting social media comments they later regretted; these estimates calculated using the percent agreeing or strongly agreeing with relevant survey items). A quarter of Americans reported seriously considering moving because of politics, and an estimated 40 percent—more than 100 million—consistently identify politics as a significant source of stress in their lives. Astonishingly, all three surveys consistently indicate that around five percent of adults report having suicidal thoughts because of politics—that’s an estimated 12 million people. [emphasis added]

“The results here indicate that Americans see politics as significantly degrading their physical, psychological and social health and that, if anything, the most recent presidential election worsened these effects.”

“Deterioration in measures of physical health became detectably worse in the wake of the 2020 election. Those who were young, politically interested, politically engaged, or on the political left were more likely to report negative effects…”

“Part of the answer may be found in the consistent findings of who is most likely to report that politics has a negative impact on their health—the young, left-leaning (Democratic identifiers), [i.e., every counselor, therapist, university professor and organization in the eating disorder community] politically interested, and politically engaged—as well as the consistently prophylactic effect of a variable that can be manipulated, i.e., political knowledge.” 

“Indeed, polls suggest that during his [President Trump] term partisan discord escalated to the point where opposing political camps disagreed not just on policy and governing preferences but even on “basic facts”. Those deepening divisions almost certainly exacerbated a pre-existing tendency for politics to take a toll on the physical, psychological and social health of Americans. Between Trump’s 2016 election victory and his 2020 re-election campaign psychotherapists reported a significant jump in patients reporting politics negatively affecting their mental health.” 

“The American Psychological Association identified politics as a major source of stress for American adults and there were sizeable increases in rates of depression, anxiety, loss of sleep, and emotional reactivity among groups with high levels of opposition to President Trump such as Democrats, racial minorities and students.”

This research article can be found here:

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0262022

As we race to become the mythical government portrayed in the cult film classic, “Idiocracy,” the ramifications of the mental health deterioration of the Republic caused by politics are readily apparent. Friendships being torn asunder by differing views on a candidate. The person with whom we hope to date must pass a “Who did you vote for test.” People saying that they will move to Canada or Mexico if a certain candidate wins. Individuals losing their own sense of identity as they embrace every issue espoused by the Tweedle Party of their choice.

As individuals, we recognize, acknowledge and understand that being fallible is part of the human condition. None of us is perfect. However, when you take fallible human beings, and put them together under the flag of one of the Tweedle Parties, they become the Wizard of Oz … all knowing, all seeing, incredibly wise, incapable of error.

The Tweedle Parties are the kids fighting in the sand box. They are also grabbing the wrists of the public and are forcibly dragging us into that sand box. To make matters worse, they are not telling us that the sand is in fact, quicksand. And if we do not resist and are pulled into the sandbox, we will surely be inundated and slowly drown in the quicksand.

So, what can we as citizens of the Republic do to get out of the sandbox? Perhaps to start with, stop exclusively surrounding yourself with sycophants who espouse the same ideas, the same theories and the same beliefs you have. When everyone is preaching the same chapter and verse, new lessons are not learned. The mind is not stimulated to grow and evolve but instead, is cemented in isolation. A number of people are credited with saying words to the effect of, “Surround yourself with people who challenge how you think, not people who nod their head and act like they agree. Those people who challenge you may scare you, but in the end, they will be the ones there for you when you need them.”

Politics do not define you. Positions on individual issues do not define you. Having an “R” or a “D” after your name does not define you. The Tweedle Parties do not have a place in elevating or demeaning your value, your self-worth. Neither Tweedle Party has unique, all-knowing insight and knowledge about the goodness of your heart, the strength in your soul or your loving and caring nature.

It is long past time that we stop focusing on our differences, differences which are played up by the media and instead start focusing on how we are so incredibly similar. How we want to live in peace, with love, in harmony. How we want to all rise as one, with grace, with honor and in doing so, we allow others to grasp our hand and to also rise.

In doing so, we will start to address those mental health issues caused by the Tweedle Parties. And hands that have been used to strike our neighbors, our brothers and our sisters with fear and malice can be turned into helping hands of cooperation and love.

Today, August 10, 2022 is my daughter’s 29^th birthday. Over the past few years on this day, I have written various messages about her, or fathers in general or eating disorders. Not this year.

This year, just photos … and her own words.

The bond, the love, between a daddy and his daughter.

The bond, the love between a daughter … and her daddy.

If you have children, give them a call, give them a hug … and tell them you love them.

A number of my past articles have largely leaned toward illustrating some of the more unsavory or questionable issues in the eating disorder community. And yet, there are certainly positive things occurring. People who inspire us through their humility, vision and selfless work. So, let’s highlight some of those good things, people, organizations and events.

Equip

Let’s start with Equip. Equip was started by Kristina Saffran, the co-founder of Project HEAL and Erin Parks, PhD. Recognizing a need for greater access to care and treatment of eating disorders, Saffran and Parks started Equip, an online platform in which a treatment team works with people suffering from eating disorders and their families. All sessions are done online. Equip assigns a five-person treatment team, a physician, therapist, peer mentor, family mentor and dietitian to the family.

Equip uses family-based therapy (FBT) as its methodology. In 2014, the Royal Australian & New Zealand College of Psychiatrists released a comprehensive report stating in part that FBT showed the most promise and highest efficacy rate for adolescents suffering from anorexia nervosa.

By the end of 2022, Equip anticipates being able to operate in all 46 states and the 4 commonwealths in the US and currently is accepted by at least 10 insurance companies.

Investors certainly believe in Equip. Equip has been able to raise $75 million in capital.

Equip issued initial findings regarding its programming. According to at least one article, Equip reported that 71% of its patients reported a reduction in eating disorder symptoms and 96% of parents reported feeling more confident about caring for a child with an eating disorder.

Can Equip provide a more effective long-term solution in the care and treatment of eating disorders? It is far too early to tell. Is this type of treatment, virtual-online, as effective as face-to-face therapy? [I believe that certain important aspects of therapy can only be provided face to face.] Again, time will tell.

What we do know is that Equip is opening new doors and exploring alternative access to care. It is backed with significant funding. Its leaders are respected and driven. We all hope that Equip has a substantive and positive impact on the industry and community and we will be hoping for great, future success.

EDCoalition and the REDC

Kudos must go out to the EDCoalition, the REDC Consortium, its president Jillian Lampert, Center Road Solutions and Katrina Velazquez.  On June 23, 2022, the House of Representatives passed The Anna Westin Legacy Act as part of H.R. 7666, the Restoring Hope for Mental Health and Well-Being Act of 2022.

This bill reauthorizes and expands the National Center of Excellence for Eating Disorders, which provides critical training, screening information, and best practices to primary care providers. The bill authorizes $5 million for each fiscal year from 2023 to 2027 to fund NCEED. The previously adopted act authorized $3.75 million.

These funds are dedicated to adapting screening, brief intervention and referral to treatment models for pediatric patients, expanding in-person and online training modules on eating disorders for physicians, consult with the Department of Defense and the Department of Veteran Affairs on treatment of eating disorders for veterans and military service members and integrate screening, intervention and referral to treatment models into electronic health record systems.

Nicely done.  Progress for one is progress for all.

NEDA

Liz Thompson, the CEO of NEDA and Geoffrey Craddock, the Chairman of the Board of NEDA, are doing an admirable job and have begun to put back together NEDA. When one peruses NEDA’s social media pages, we find a wide diversity of topics. Information about the different types of eating disorders, body diversity, information about important bills being considered in Congress, the importance of research and stigma.

My past interaction with NEDA may lead one to question why I would be including them in “an uncharacteristic, positive article.” Ultimately, when good work is being accomplished, when an organization can in some ways, seemingly reinvent itself, when an organization becomes focused and directed, we should certainly embrace and encourage good works. Ms. Thompson has a proven, past record of success in prior organizations.

A strong focused NEDA can help so many families. And that ultimately should be everyone’s goal … to help families.

Linda and Jack Mazur

The work being done by Linda and Jack Mazur should inspire us all. In 2016 their beloved daughter Emilee was taken after fighting eating disorders for ten years. The revolving door of treatment imposed by insurance companies and the lack of knowledge about eating disorder of medical providers in the late aughts contributed to Emilee’s condition.

Now, Linda and Jack Mazur are fighting back … with humility, knowledge and grace.  Their new podcast series, “Once Shattered, Picking Up the Pieces” is a compelling listen. Their book, “Emilee – The Story of a Girl and Her Family Hijacked by Anorexia” is a must read. In the last month, Jack and Linda also received approval for their 501(c)(3) foundation, “The Emilee Connection.”

Grief certainly impacts each person in different and unique ways. In the case of Linda and Jack, the daily heartache they feel has manifested itself in a manner which provides our shared humanity the opportunity to become bigger, better, more transparent and more soulful.

Families and Patients

Finally, and perhaps most importantly, the stories of recovery, of resiliency, of overcoming life-threatening obstacles which are placed before our daughters and sons before they have the chance to find their place in life can’t help but fill us with hope for a greater tomorrow.

When we see the evolution of the heart and embracing of life shown by the many who first suffered from, and then who have overcome this insidious illness, how can that not let your spirit soar? When I see the young people who I have helped get into treatment start to fully live their lives … when I see marriages, and graduations, and laughter and love, when I am called a “second dad,” how can that not be a helping hand extended to lift me up and keep me from drowning in a pool of despair?

The times a parent has told me, “Thank you, you helped save my child’s life,” they can’t possibly know that to me it is, “No … it is you and your beautiful child who are saving mine. For it is you who are keeping my daughter alive in your head and your heart. And the only thing I ask of you for this precious gift is … to pass it on to others. Through your own work, your own passion, your own love.”

That love, that strength, that resiliency, that burning light of hope, is the greatest gift our community has.  The families are the sole reason for this community’s existence.

Our families deserve the absolute best from our community. Because our families are the greatest gift to our community.

The eating disorder community experienced perhaps more than its usual share of oddities, dysfunctionalities, egos out of control and lack of progress in the first half of 2022. And yet, one person managed to elevate herself to the very bottom of the bottom of the barrel.

A New Dr. Death

Jack “Dr.  Death” Kevorkian was a pathologist and euthanasia proponent. In 1997, Dr. Kevorkian was put on trial for his direct role in a case of voluntary euthanasia involving Thomas Youk. Youk suffered from Lou Gehrig’s disease, a/k/a ALS. Kevorkian was convicted of second-degree murder and served 8 years of a 10-to-25-year prison sentence.

In mid-March 2022, for reasons known only to God and broccoli, the Journal of Eating Disorders published an article entitled, “Terminal Anorexia Nervosa: Three Cases and Proposed Clinical Characteristics.”  Its lead author was the new “Dr. Death,” Jennifer L. Gaudiani.

Gaudiani’s article:

(1).     Postulated that severe and enduring anorexia nervosa is a terminal illness;

(2).     Attempted to establish clinical characteristics for those patients whom Gaudiani considers to have Terminal Severe and Enduring Anorexia Nervosa (“TSEAN”);

(3).     Attempted to establish objective, clinical guidelines for TSEAN.

The private response was immediate.

Gaudiani should be commended for accomplishing a herculean task that most considered virtually impossible. And that is … she was able to bring together, to unify as one, all persons, doctors, research professionals, organizations and all other aspects of the eating disorder community and industry in one great, collaborative. To a person, every entity looked upon Gaudiani’s viewpoints with horror and derision. Clinical doctors, research professionals and advocates used the following words to describe Gaudiani’s article, “reprehensible, appalling, irresponsible and horrifying.” Naturally, public admonition came only from those outside of the eating disorder realm since “sacred cows” in the eating disorder community are deemed untouchable. Apparently, no matter what.

Not only was Gaudiani the author of this article, but she was the internist for the three guinea pigs … err, patients who were the subjects of the article. Three souls for whom Gaudiani was complicit in, if not the catalyst for, removing the very last vestige of one of the most important aspects of recovery. That is … hope.

To say there is a legion of troubling issues with Gaudiani’s article and thinking, or lack thereof, would be charitable. Nonetheless, let’s address just a few of the more obvious issues.

First, the article did not mention, let alone explain that severe anorexia can decrease brain volume. Studies indicate that individuals with prolonged anorexia have the most significant reductions in brain volume among all study participants.

Shrinkage of the brain and brain atrophy can affect cognitive functioning. The National Institute of Neurological Disorders and Stroke states that brain atrophy can result in several health conditions, including:

• Dementia: Creates problems with memory, abstract thinking, learning, organizing, and planning
• Aphasias: Involves problems speaking and understanding language
• Seizures: Characterized by convulsions and sometimes a loss of consciousness

Second, did Gaudiani take into account oxytocin levels in the brain? Research evidence shows that varying levels of oxytocin, a brain chemical, have an impact on anorexia. Now, three new studies of the hormone—best known for its role in bonding lovers to each other and parents to their children—suggest that addressing oxytocin levels may be a viable treatment for anorexia, which as we know, currently has no effective pharmacological medication and relies for the most part on therapy.

Third, Gaudiani’s “treatment” of her patients violate the AMA Code of Ethics Opinion 5.7 which states in material part: Instead of engaging in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life. Physicians:

1. Should not abandon a patient once it is determined that cure is impossible.
2. Must respect patient autonomy.
3. Must provide good communication and emotional support.
4. Must provide appropriate comfort care and adequate pain control.

Fourth, professional groups, such as the World Medical Association, the British Medical Association, the American Medical Association,and the American Psychiatric Associationhave all expressed unwavering opposition to MAiD.

Forty (40) states in the United States ban assisted suicide.

In an article published in July of 2021 by the Canadian Medical Association Journal entitled, “Deromanticizing medical assistance in dying,” the authors stated in material part as follows:

“Dr. Ashe speaks of providing MAiD as an “intimate and sacred moment.” We trust that he meant the interaction with the suffering patient and family before administration of the medications to end a life. Rocuronium, which paralyzes the neuromuscular junction and terminates life, does not allow for any expression of what the patient is feeling. We do not believe it is in the best interest of others to portray MAiD as something people should seek instead of natural death…”

“… writing about MAiD in a romanticized way may influence vulnerable people to seek MAiD through social learning, whereby they identify with the person portrayed and seek to copy their behaviour. This has been previously reported in 2003 in Switzerland.”

“We would not have the medical advances and healthier, longer lives we have today if previous clinicians all considered an easier death to be the solution to the burden of disease. We need to continue to research and seek ways of preventing and relieving suffering.”

Then there is the ethical aspect, or lack thereof, of Gaudiani’s article. Some ethics experts define Gaudiani’s conduct as abandonment. Bioethics writer Wesley J. Smith, writing in the National Review about abandonment stated, “Then why not allow an intentional, lethal opioid overdose as a “treatment” for opioid use disorder? Once you open the door for one by redefining it as “terminal,” you won’t be able to keep others out. When psychiatrists give up on their mentally ill patients — and indeed, are allowed to help them commit suicide — who will defend the value andcontinued importance of their lives? How will these very unhappy people be kept among us during their darkest days?”

When interviewed, Gaudiani insisted that physician assisted suicide is not suicide: “MAid (Medical Assistance in dying) is offered to individuals whose death is inevitable within six months from an underlying disease process; it provides patients a choice in how they die, not whether they die. It is not a means of suicide.” “When death is inevitable?” “… not a means of suicide?” Good Lord.

Gaudiani’s statement is nothing more than pedantic sophistry. Choosing a place, a method, and a time to end one’s own life is suicide. Besides no doctor can predict with certainty how long a patient will live. Treating MAiD as a natural end to life for anorexia sufferers is at best, medical neglect. At worst it is aiding and abetting negligent homicide. Doctors persevere with patients who suffer from cancer or heart disease or diabetes for years. But apparently, Gaudiani has become “Karnak the Magnificent,” who can accurately divine a date of death and assist in administering the final coup de gras. 

As recently as last month, The Denver Post published an op-ed article eviscerating Gaudiani.

https://www.denverpost.com/2022/05/20/doctor-assisted-suicide-mental-illness-colorado-eating-disorder/

I have spoken with at least two parents whose daughters are suffering from anorexia. Each parent was disheartened by Gaudiani’s article. Each had previously respected and looked up to Gaudiani. But that was before. That was before Gaudiani became the perverse proponent of removing that final, tenuous grasp of life to which so many people cling … and that is hope.

Desmond Tutu is credited with saying, “Hope is being able to see there is light despite all of the darkness.” Without question, hope is that one last flickering candle in a room of darkness and despair.

Gaudiani seeks to extinguish that candle.

Imagine being in that dark room of despair, afraid and in pain. One lone candle sitting on a table. Its light, flickering, the wick slowly burning down, the one last vestige of light barely hanging on. You then discern a spectral figure in the room. And suddenly, dark eyes appear, staring at you. You then hear a haunting voice barely above a whisper murmur, “All … hope … is … gone.” You sense, you feel a puff of breath. And then, that last light, all hope, your very life, is extinguished.

Plunging you into permanent darkness.

So, your child’s eating disorder has progressed to a level requiring residential treatment. Her physical health is impacted. His mental and emotional well-being is impaired. The biological aspects of this illness have compromised their ability to think, to reason and at times, to save their own lives. You live in a grey twilight every day fearing that today will be the day you receive that horrific call that any parent dreads.

Now, envision as you are talking with your beloved child on the telephone she tells you, “Daddy, while we were discussing my pronouns in group therapy today …”

Discussion of Pronouns?

In group therapy?

For (hopefully) lifesaving, eating disorder treatment

Pronouns?

Lest you think that is Twilight Zone thinking and would never happen … It has and is continuing to happen. And it has caused harm.

On at least two occasions, I have been approached by mothers whose daughters were in treatment. On both occasions, each daughter stated how uncomfortable it was for her to be subjected to the “pronoun merry-go-round.” [my term]

And so once again, we find the mental health treatment arena being hijacked by social justice warrior, left-wing radical political activists. Activists whose goal is not to lead the way to a greater understanding of the biological, genetic and physiological aspects of eating disorders. Instead, their goal is to dictate the ideological and linguistic territory leading to authoritarian control over the manner in which our loved ones receive care and treatment for mental health issues.

We are living in a “microaggression culture” where young persons have been raised to believe themselves and their experiences to be universally unique and therefore demanding of heightened levels of sensitivity and respect. Just as no two actual snowflakes are exactly alike (mostly because their composition is affected by their journey to the ground) the metaphorical versions are known for fragile hypersensitivity born of narcissism. This is the generation which was gifted participation trophies and where mommy and daddy swooped in to their rescue at the slightest hint of adversity.

So, in order to not cause undue stress upon the Snowflake Generation, and to ensure that they are receiving the absolute best eating disorder/mental health care possible, let’s review the latest university-based studies on how best to incorporate the proper use of pronouns into eating disorder group therapy sessions.

Uh … ok.

Let’s lower the bar a bit. How about ANY independent, reputable third-party research study on how best to incorporate the proper use of pronouns into eating disorders group therapy sessions?

And yet …

Forcing patients receiving eating disorder treatment in residential programs to discuss pronouns is happening every weekday. Even though there is no basis in research. No connection between pronouns and recovery from the various eating disorders. No reputable reasoning supporting incorporating pronouns into the therapy arena. And taking valuable time away from actual evidence-based therapies.

So, questions must be asked … why are some treatment centers and so-called professionals doing that? Why are unsanctioned, unresearched talking points being incorporated into eating disorders group therapy? Particularly a topic grounded in social justice activism such as pronouns.

Ok, let’s discuss pronouns. First, let’s review the number of pronouns. After conducting some research, I found a website containing this list of pronouns:

• all
• another
• any
• anybody
• anyone
• anything
• as
• aught
• both
• each
• each other
• either
• enough
• everybody
• everyone
• everything
• few
• he
• her
• hers
• herself
• him
• himself
• his
• I
• idem
• it
• its
• itself
• many
• me
• mine
• most
• my
• myself
• naught
• neither
• no one
• nobody
• none
• nothing
• nought
• one
• one another
• other
• others
• ought
• our
• ours
• ourself
• ourselves
• several
• she
• some
• somebody
• someone
• something
• somewhat
• such
• suchlike
• that
• thee
• their
• theirs
• theirself
• theirselves
• them
• themself
• themselves
• there
• these
• they
• thine
• this
• those
• thou
• thy
• thyself
• us
• we
• what
• whatever
• whatnot
• whatsoever
• whence
• where
• whereby
• wherefrom
• wherein
• whereinto
• whereof
• whereon
• wherever
• wheresoever
• whereto
• whereunto
• wherewith
• wherewithal
• whether
• which
• whichever
• whichsoever
• who
• whoever
• whom
• whomever
• whomso
• whomsoever
• whose
• whosever
• whosesoever
• whoso
• whosoever
• ye
• yon
• yonder
• you
• your
• yours
• yourself
• yourselves

Then of course, there are the “gender neutral, gender inclusive pronouns”:

HE/SHE	HIM/HER	HIS/HER	HIS/HERS	HIMSELF/HERSELF
zie	zim	zir	zis	zieself
sie	sie	hir	hirs	hirself
ey	em	eir	eirs	eirself
ve	ver	vis	vers	verself
tey	ter	tem	ters	terself
e	em	eir	eirs	emself

If you are going to enforce pronouns on people suffering from eating disorders, you need a complete list.

Since some are attempting to impose their “Pronouns With No Research Basis” agenda in the care and treatment of eating disorders without consequences or push back, one is justified in wondering how much further things will devolve. Will gender identities and gender expression become part of the eating disorder treatment lexicon?

If the social justice warrior, left-wing radical political activist in the guise of a therapist seeks to “educate and inform” eating disorder patients about “their gender identity’ and “gender expression” isn’t that a clear example of radical social constructionists bullying opponents into submission?

Certainly, bullying tactics are not an uncommon weapon utilized by the radical political activist. For example, a school district in Wisconsin recently opened a Title IX sexual harassment investigation. This investigation is not being conducted against teachers, nor administrators nor teacher volunteers nor any district employees. No.

This investigation is being conducted against three, 8^th grade boys. So what was their heinous crime?

They are accused of using the “wrong pronouns” by not using a student’s preferred “they/them” pronouns. 

The “thought police” at the Kiel Area School District apparently believe that any so-called “mispronouning” is punishable speech under Title IX. Imagine a finding of sexual harassment perpetrated by your child becoming part of your child’s education file. That allegation could haunt those three, 8^th grade boys for decades. Certainly, impacting college admissions and beyond. All for the horrific crime of mispronouning.

The Kiel Area School District appears to believe that any “mispronouning” is punishable speech under Title IX. During the investigation of these claims, attorneys for the families discovered information revealing that a young female student was given in-school suspension for “sexual harassment” based on a single statement using an allegedly “wrong” pronoun—and the statement was said to a third party, not even to the allegedly “misgendered” student.

To compound an already ridiculous situation, on Thursday, May 26, 2022, the District announced it had closed the Title IX investigation. However after receiving public backlash against their actions (allegedly also including bomb threats), the District and its community announced it had cancelled its annual Memorial Day Parade and the remainder of the school year would be conducted virtually.

Community events. In person education. All cancelled. A community infighting. Anger. Hatred. Division. Because of mispronouning.

Make no mistake. If a treatment professional wishes to parade their virtue signaling by utilizing pronouns, that is certainly their right and … privilege. They are ostensibly adults not receiving eating disorder treatment. In addition, if a patient in treatment during individual therapy wishes to address his/her pronouns and the manner in which it is impacting them, by all means address it. After obtaining that patient’s consent, utilize that as part of the overall manner in which bullying and trauma can exacerbate eating disorders. Take intelligent action and responsible conduct. A person’s heart is more accurately shown through their actions and conduct and not just their words or how they “label” themselves.

However, with regard to mandatory inclusion of discussing pronouns in treatment centers which drag that societal affectation into the eating disorder group therapy rooms, I am going to do something I have never done before …

MOMS, DADS … IF YOUR CHILD IS IN A TREATMENT CENTER OR PROGRAM IN WHICH “PRONOUNS” ARE A MANDATORY, REGULAR ASPECT OF GROUP COUNSELING, GET YOUR CHILD OUT OF THAT PROGRAM IMMEDIATELY. YOU MAY ALSO WISH TO CONTACT YOUR INSURANCE BENEFITS PROVIDER AND ADVISE IT THAT THAT PARTICULAR ACTIVITY IS GOING ON IN THAT TREATMENT CENTER.

Moms … dads … your child is the most precious thing in your heart. Don’t have your loved one’s care and treatment be sabotaged by those who place political correctness and social engineering over the welfare of your beloved child.

The eating disorder community does not have an oversight agency, is without any type of dire consequences for reprehensible conduct and is without ramifications for bad faith behavior for those who exploit our loved ones for the sake of making a profit. There is no organization which has had the means nor will power to stop bad actors.

Organizations with a checkered history, for those who hurt people entrusted to their care have found ways to protect themself.

They start by simply changing their name. They can file a fictitious name certificate, change all internet references about their old name and substitute their new, slick fictitious name. They can market that they are a brand-new company. And all the while, they remain the same. They fool most of the people most of the time.

After all, who is going to check on things in the eating disorder community? The saying, “If a lie is printed often enough, it becomes a quasi-truth, and if this “truth” is repeated often enough, it becomes an article of belief, a dogma, and men will die for it.” has been in existence for thousands of years (although most recently attributed to Joseph Goebbels, the propaganda minister for the Third Reich.)

Without consequences, bad actors do not have to conduct thorough background checks on prospective employees. They can pay a low hourly rate to employees who have the most interaction with patients, employees they refer to as “their MVPs.” [Shouldn’t that really be “MVE,” Most Valuable Employees?]

They can become an organizational cesspool attracting reprobates and predators. They can invent any treatment protocol they desire. They can invent new names for their employees (We made up our corporate name … let’s just make up job titles too. Who needs Direct Care Staff when they can be called … Behavioral Health Technicians!)  They can concoct efficacy numbers which would be cartoonishly embarrassing if they didn’t also contribute to deception.

They can do all of this without fear of reprisal. And why? Because there are no consequences. There are no ramifications. There is no oversight. There is no governing board, person or agency who can or will impose draconian measures to keep in check bad faith conduct.

Enough … Enough.

In the past month, three courageous yet frightened patients entrusted to the care of Castlewood, patients who were “allegedly” abused and betrayed by Castlewood, have become the faces, the public voices in three separate lawsuits filed in federal court against Castlewood Treatment Center d/b/a Alsana. Yes, Castlewood. That Castlewood. The Castlewood which never went away. The same Castlewood which was, and still is using Alsana merely as a pasteboard mask. There are other lawsuits against Castlewood which are waiting in the wings, undoubtedly, to be filed.

The same Castlewood which, in an article appearing in the St. Louis Dispatch on February 1, 2022, contains the following, “In a statement, Alsana CEO Gayle Devin called Doe’s lawyer, Steven R. Dunn, “a well-known critic of Alsana and the eating disorder treatment industry generally.” She further stated, “We will aggressively defend ourselves against these baseless claims in court.”

Ms. Devin also stated, “We take seriously allegations of misconduct by our staff, and as we made clear – in the context of a completely unrelated matter last week – we are prepared to thoroughly investigate those claims when they arise,” Devin said, referring to a statement last week, in which she said new admissions were being halted at two residential programs and one outpatient program. That statement said the decision was triggered by allegations that “employees may have been involved in inappropriate conduct involving a client receiving outpatient care at our St. Louis program.” [emphasis added]

Ms. Devin, you are to be commended for “thoroughly investigating” claims after your patients have already been hurt. But here is an idea which may seem novel … implement a thorough vetting process doing a complete background check on prospective employees before they become employees. Better yet, have an outside third party do the pre-employment investigation, drug screening and have a hand in the employment process. In that way, those steps significantly lessen the likelihood of having any more patients be harmed.

On March 1, 2022, Ms. Devin issued another statement. This statement is hard to find. Apparently, it was only sent to Alsana’s “partners.” Those entities which potentially refer patients to them. So, why wasn’t it sent out to the public? Why wasn’t it extensively shared on social media?

If a person looks for it on Alsana’s website? No, nothing to see there, move along, move along. When a person looks at Alsana’s LinkedIn page, no nothing to see there either, move along, move along. [But at about the same time Ms. Devin’s email blast was going out to Alsana’s partners, Alsana’s LinkedIn page posted an article about Channing Tatum saying his Magic Mike body was not a healthy body!] Channing! Say it ain’t so!

So, let’s allow the public to read Ms. Devin’s statement:

In evaluating Ms. Devin’s statement, if a “thorough investigation” had been done, in less than one month, Castlewood would have done the following:

1. Identify all possible issues;
2. Retain a law firm;
3. Have that law firm draft a Request for Proposal (“RFP”) to identify the issues to be researched;
4. Accept responses to that RFP;
5. Choose the organization best suited to this investigation;
6. Negotiate with them and their cost for this exhaustive investigation;
7.  Have that “independent quality consultant” assign employees to this project;
8. Extensively review Castlewood’s long, sordid history;
9. Interview all employees and former employees;
10. Interview current and former patients (Oh… that’s right, you call them “clients” … it makes them seem less in need of care and more like corporate commodities), especially those patients who had been victimized;
11. Review the lawsuits which had been filed during this time and do a thorough investigation into the allegations, review documented evidence and speak with all attorney’s involved;
12. Conduct due diligence into safety and security measures implemented at other eating disorder treatment centers;
13. Conduct an exhaustive study of past surveys and research projects undertaken by AED, iaedp and other organizations;
14. Formulate the price tag for implementing changes;
15. Request and review bids from various third parties to perform the work to be done;
16. Implement the wholesale changes recommended by this independent consultant, which implementation would undoubtedly require construction work and remodeling at the St. Louis facility;
17. Fix the broken-down septic system in St. Louis so that new patients do not have the pungent aroma of fecal matter greeting them when they first arrive in St. Louis;
18. Then, implement these same studies at all the Castlewood facilities.

And to think that undoubtedly, this “thorough investigation” was done in the span of one month. And the important findings from “thorough investigation” were:

“While that review resulted in very positive feedback, there is always room for improvement, and Alsana is in the process of acting based on specific recommendations that came out of that review process. We are implementing clinical and safety program enhancements in our St. Louis program intended to reinforce company policies, including supplemental training for all Alsana program teams in St. Louis, and plan to expand these clinical and safety program enhancements to all program sites nationwide in the coming months.”

Of course, no one knows what deficiencies were found because well, there is no transparency about that. And no one knows what specific “enhancements” are allegedly being implemented because well, there is no transparency about that either. Has Castlewood filed any complaints with any administrative agencies regarding those offending employees? We do not know.

We do know that even before Castlewood has completed its implementation of these alleged new changes, they are going to start accepting patients … err, clients again on March 2, 2022! YAY! Those private equity owners are not going to wait forever for the money spigot to be turned back on. Nothing to see here, move along, move along.

All of that coming from the same CEO who regarding the lawsuits, in the span of less than 24 hours, “thoroughly investigated” and reviewed all documents and evidence, interviewed former employees and patients, and then in compassionate support for her former patients, stated in the press that these were “… baseless claims in court.” Baseless claims which resulted in Castlewood firing how many employees? 4? 5? 6? More? Oh… that’s right. Castlewood has not been transparent about that either. Which brings up the seminal questions, “Ms. Devin, if the claims are baseless, why did you fire those employees?” If the claims are baseless, why the need for this exhaustive study and alleged changes to the program?

Tthe exact same expression, “baseless claims” was once utilized by one of Ms. Devin’s infamous predecessors, the now disgraced former CEO of Castlewood, Mark Schwartz. [As an aside, perhaps the apple didn’t fall far from the tree.] Certainly, Ms. Devin is to be applauded for being able to conduct her “thorough investigation” in less than one day and then label in the press as “baseless,” litigation instituted by her former patients who were so harmed by her employees, employees who were fired. And yet employees Ms. Devin and Castlewood are now required to stand behind and support.

Ms. Devin’s message was trumpeted loudly and clearly. And that is, “If you are a patient at Castlewood, and you are hurt by an employee and then seek compensation for your injuries, we will not only turn our back on you, but we will attack you in the media. Who cares if we cause your condition to worsen? How dare you come after us and our profit margin?

We have a name for people like that Ms. Devin … they are called bullies.

And bullies are only allowed to thrive in communities which have no consequences, ramifications or accountability. Bullies are only allowed to thrive in communities where there are no people of uncommon courage, strength, and resolve. People who remain victims. But, regarding the eating disorder community, that is no longer the case. I am not speaking about the legal system. Although the legal system can and will impose consequences where needed. I am instead referring to those incredible young women who are standing up to be counted. Heroes all.

So, Ms. Devin, as Castlewood opens its arms to welcome new patients … I mean clients, on March 2, 2022, there are a few, absolute truths of which you should be aware.

First, you are the face of those employees you fired because of the harm they caused to those young souls entrusted to your care.

You are the face of the company whose primary purpose is to make a profit at any and all costs.

You are the face of the company that cannot even be truthful about its own name.

You are the face of the company which “allegedly” hurt a number of young souls entrusted to your care.

As for me being a well-known critic of the eating disorder industry, perhaps so, but more importantly, I am merely a conduit, a means, through which young women, struggling and in such pain, are finding … renewed hope at life.

Young women who have been so hurt.

Young women who dare to stand up and be counted.

Young women who dare to say, “No more. No longer will I stand idly by and let others be hurt.”

Young women who have found or are finding their incredible voices.

Young women filled with renewed strength, with resolve, with love, with hope for the future.

Young women who have already won.

No matter what lies ahead.